Direct Oral Anticoagulants Versus Warfarin in Left Ventricular Thrombus: A Systematic Review and Meta-Analysis.
Journal
American journal of therapeutics
ISSN: 1536-3686
Titre abrégé: Am J Ther
Pays: United States
ID NLM: 9441347
Informations de publication
Date de publication:
02 Aug 2021
02 Aug 2021
Historique:
entrez:
13
8
2021
pubmed:
14
8
2021
medline:
14
8
2021
Statut:
aheadofprint
Résumé
There are conflicting results regarding the safety and efficacy of direct oral anticoagulants (DOACs) in the management of left ventricular thrombus (LVT) compared with the vitamin K antagonist warfarin. What is the safety and efficacy of DOACs in the management of LVT compared with warfarin? Randomized clinical trials and cohort studies in the MEDLINE and Cochrane databases from inception till April 4, 2021. The present analysis is a systematic review and meta-analysis. Desired outcomes were all-cause mortality, complete resolution of LVT, stroke and systemic emboli, and major bleeding. The risk ratio (RR) of the outcomes and 95% confidence intervals (CIs) were calculated using a random-effects modeling approach. Twelve studies with a total of 2322 patients were included. There was no difference between the 2 interventions in the resolution of LVT [RR 0.97 (CI 0.93-1.02)], stroke and systemic embolism [RR 0.95 (CI 0.63-1.45)], bleeding [RR 1.14 (CI 0.81-1.60)], and all-cause mortality [RR 0.99 (CI 0.67, 1.46)]. DOACs and warfarin have comparable safety and efficacy outcomes in the management of LVT.
Sections du résumé
BACKGROUND
BACKGROUND
There are conflicting results regarding the safety and efficacy of direct oral anticoagulants (DOACs) in the management of left ventricular thrombus (LVT) compared with the vitamin K antagonist warfarin.
STUDY QUESTION
OBJECTIVE
What is the safety and efficacy of DOACs in the management of LVT compared with warfarin?
DATA SOURCE
METHODS
Randomized clinical trials and cohort studies in the MEDLINE and Cochrane databases from inception till April 4, 2021.
STUDY DESIGN
METHODS
The present analysis is a systematic review and meta-analysis. Desired outcomes were all-cause mortality, complete resolution of LVT, stroke and systemic emboli, and major bleeding. The risk ratio (RR) of the outcomes and 95% confidence intervals (CIs) were calculated using a random-effects modeling approach.
RESULTS
RESULTS
Twelve studies with a total of 2322 patients were included. There was no difference between the 2 interventions in the resolution of LVT [RR 0.97 (CI 0.93-1.02)], stroke and systemic embolism [RR 0.95 (CI 0.63-1.45)], bleeding [RR 1.14 (CI 0.81-1.60)], and all-cause mortality [RR 0.99 (CI 0.67, 1.46)].
CONCLUSIONS
CONCLUSIONS
DOACs and warfarin have comparable safety and efficacy outcomes in the management of LVT.
Identifiants
pubmed: 34387565
doi: 10.1097/MJT.0000000000001432
pii: 00045391-900000000-98006
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors have no conflicts of interest to declare.